TRICARE's Outpatient Prospective Payment System (OPPS) was implemented on May 1, 2009.
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Quarterly Updates
Payment Status by HCPCS Code
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Ambulatory Payment Classifications (APCs) with Status Indicators (SIs) and Payment Rates
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Payment Status Indicators
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Payment Status by HCPCS Code - Drugs
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Maternity Diagnosis
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Annual Updates
OPPS Pricing Elements
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Statewide Cost to Charge Ratios
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Provider Information Updates
Zip to Wage Index Crosswalk
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OPPS Provider File
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Provider Types contained in the OPPS provider file:
- 00 = Short Term Facility
- 02 = Long Term
- 03 = Psychiatric
- 04 = Rehabilitation Facility
- 06 = Hospital Distinct Parts
- 07 = Rural Referral Center
- 14 = Medicare Dependent Hospital
- 15 = Medicare Dependent Hospital/Referral Center
- 16 = Sole Community Hospital
- 17 = Sole Community Hospital/Referral Center
- 21 = Essential Access Hospital
- 22 = Essential Access Hospital/Referral Center
- 47 = Community Mental Health Centers
- 49 = Psychiatric Distinct Part
- 50 = Rehabilitation Distinct Part
Provider Types (download)
TRICARE Reimbursement Manual